口腔癌是近年來危及國人健康的主要疾病,居男性十大癌症發生率及死亡率的第五位,外科手術切除是口腔癌的主要治療方式,口腔部位的手術可能造成病人術後極大的身體不適,但卻極少研究探討該方面之問題,因此以縱貫性設計探討口腔癌切除手術病患術後一週內症狀嚴重度及其變化。 本研究於民國91年4月到11月期間,以立意取樣於北區某醫學中心進行資料收集,以0-10分之數字性量表測量病患之嚴重度,其包括疼痛、睡眠問題、疲倦、食慾不振、飢餓、吞嚥困難、溝通困難、呼吸困難、咳嗽、口腔不適、便秘、腹瀉、噁心與嘔吐等14項文獻提及常見於術後病人的症狀,6個收案時間點包括手術前一天、術後第一天、第二天、第三天、第五天及第七天進行量表填寫,共完成33位個案的資料收集,資料以SPSS統計軟體進行描述性統計(包括次數分配、平均值、標準差、百分比)、皮爾森積差相關(Pearson’s correlation)、單因子變異數分析(One-WAY ANOVA)及重複測量變異數分析(Repeated measures ANOVA)。 研究結果發現口腔癌切除之病患術後一週身體不適以吞嚥困難、疼痛、睡眠問題、食慾不振、疲倦、咳嗽及口腔不適是七個最嚴重的症狀,此七個症狀彼此呈正相關,手術後當天至四天維持中度的嚴重度,第五、六天呈輕度嚴重度,本研究之發現有助於醫護人員瞭解口腔癌切除病患手術後問題,可直接貢獻臨床該群病患之照護。 關鍵字:口腔癌、口腔癌手術、症狀、嚴重度、疼痛
Oral cancer has been ranked as one of the major cancers in Taiwan. Surgery is the major treatment modality for these patients. The purposes of this longitudinal study were to examine symptoms and severity, and their relations in these patients during the first week of oral cavity surgery. Data were collected on the day before surgery, and day 1, 2, 3, 5,day 7 post surgery, with total 6 times of data collection. Through literature review, we examined 14 symptoms. Each symptom was assessed in the above-mentioned time points with 0 to 10 Numeric rating scale (NRS). Data was analyzed by descriptive statistics, Pearson’s correlation, Analysis of Variance (ANOVA), and repeated measured ANOVA. A total of 33 subjects were recruited. The 7 most severe symptoms ranked as their severity are (1) difficult in swallowing, (2) pain, (3) sleep problem, (4) anorexia, (5) fatigue, (6) coughing, and (7)oral discomfort. These symptoms correlated to each other. In general, it showed mild to moderate severity of symptoms during first four days of surgery, and these symptoms dropped down from day 5 post surgery. The results of suggest that health care professionals should pay more attention and care on patients receiving oral surgery to prevent and deal with their post-operative symptoms and to enhance their care quality. Key words: oral cancer, oral cavity cancer surgery, symptom, severity, pain.